Liquid Lounge Hydration Dba Ideal Vitality Wellness

Primary specialty

Laboratory Management Specialist/TechnologistTaxonomy code 246QL0900X

Legal business name

LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS

Doing business as

Ideal Vitality Wellness

Practice address

5126 Park Rd Ste 2C
Charlotte, NC 28209-3748

Phone

(704) 247-7281

Fax

(704) 800-5655

NPI assigned

Feb 10, 2026

Last updated

Feb 10, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Guillaume, BSN, RNNPI 1881546240

Title

Operator

Phone

(704) 247-7281

Specialties & licenses 2

Addresses

Other names 1

• Ideal Vitality Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Guillaume, BSN, RN

  • Community Health Registered Nurse
  • Charlotte, NC
  • NPI 1881546240

  Laboratory Management

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1720930183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 PARK RD STE 2C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093748",
            "telephone_number": "704-247-7281",
            "fax_number": "704-800-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 PARK RD STE 2C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093748",
            "telephone_number": "704-247-7281",
            "fax_number": "704-800-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "GUILLAUME",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "704-247-7281",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "246QL0900X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ideal Vitality Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Eva Lipponen, PA-C
• Quinisha Lipscomb, PHARMD
• Kelli Lipsey, LCSW
• Jordan Douglas Lipton, M.D.
• Liquid Lotus, LLC (Health Solstice Coaching)
• Jennifer Liriano Suarez, PHARMD
• Amanda L Lis, MS, LMFT
• Lisa a. Seropian, Psy.D., P.a.
• Lisa E. Cyzner, PHD, Otrl
• Courtney Alice Lisboa, D.O.

• Pathology Specialist/Technologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pathology Specialist/Technologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.